title: The impact of hepatitis C on labor force participation, absenteeism, presenteeism and non-work activities.
abstract: OBJECTIVE
  Between 2.7 and 3.9 million people are currently infected with the hepatitis C virus (HCV) in the United States. Although many studies have investigated the impact of HCV on direct healthcare costs, few studies have estimated the indirect costs associated with the virus using a nationally-representative dataset.
  
  
  METHODS
  Using data from the 2009 United States (US) National Health and Wellness Survey, patients who reported a hepatitis C diagnosis (n = 695) were compared to controls on labor force participation, productivity loss, and activity impairment after adjusting for demographics, health risk behaviors, and comorbidities. All analyses applied sampling weights to project to the population.
  
  
  RESULTS
  Patients with HCV were significantly less likely to be in the labor force than controls and reported significantly higher levels of absenteeism (4.88 vs. 3.03%), presenteeism (16.69 vs. 13.50%), overall work impairment (19.40 vs.15.35%), and activity impairment (25.01 vs. 21.78%). A propensity score matching methodology replicated many of these findings.
  
  
  CONCLUSIONS
  While much of the work on HCV has focused on direct costs, our results suggest indirect costs should not be ignored when quantifying the societal burden of HCV. To our knowledge, this is the first study which has utilized a large, nationally-representative data source for identifying the impact of HCV on labor force participation and work and activity impairment using both a propensity-score matching and a regression modeling framework.
  
  
  CONCLUSIONS
  All data were patient-reported (including HCV diagnosis and work productivity), which could have introduced some subjective biases.
authors.affiliation: Health Sciences Practice, Kantar Health, New York, NY, USA. marco.dibonaventura@kantarhealth.com
authors.forename: Marco daCosta
authors.initials: Md
authors.lastname: DiBonaventura
authors.forename: Jan-Samuel
authors.initials: JS
authors.lastname: Wagner
authors.forename: Yong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Gilbert
authors.initials: G
authors.lastname: L'Italien
authors.forename: Paul
authors.initials: P
authors.lastname: Langley
authors.forename: W
authors.initials: W
authors.lastname: Ray Kim
mesh_terms: D000041:Absenteeism; D000223:Adaptation, Psychological; D000328:Adult; D003430:Cross-Sectional Studies; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006526:Hepatitis C / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012307:Risk Factors; D013315:Stress, Psychological; D014481:United States / Q000453:epidemiology